Gallant Sarah M, DeCoste Kelly, Norris NaDeana, McConnell Erin, Al-Rassi Joyce, Churchill Megan, Higgins Amanda, Rothfus Melissa, Mann Cynthia, Benoit Britney, Curran Janet, Aston Megan, Cassidy Christine
Dalhousie University, Halifax, Nova Scotia.
Izaak Walton Killam Health, Halifax, Nova Scotia.
Hosp Pediatr. 2025 Mar 1;15(3):e108-e120. doi: 10.1542/hpeds.2024-008078.
The Eat, Sleep, Console (ESC) model of care is an innovative care approach for infants diagnosed with neonatal abstinence syndrome, improving patient and health system outcomes for this equity-deserving population. Little is known about sustainably implementing this model into practice. The objective is to map evidence on implementing the ESC model into clinical practice, including strategies, barriers and facilitators to implementation, and evaluation outcomes.
Data sources include MEDLINE, Embase, CINAHL, PsycINFO, Google Scholar, and websites identified by a Google search. The study selection included articles exploring the implementation or evaluation of the ESC model in clinical practice since its 2017 conception. Two reviewers independently screened each study using a predetermined screening tool. Data were extracted by 2 independent reviewers from included articles.
The review identified 34 studies. Barriers to implementing the ESC model include resource limitations and systemic oppression and bias. Facilitators include health care provider education and empowerment of parent engagement. The most reported cluster of strategies (31.6%) included training and educating stakeholders. Gaps were noted in the exploration of implementation outcomes/processes, and equity implications on implementation.
The ESC model of care has been successfully implemented in various settings with positive patient and health system outcomes, including decreased hospital stay and pharmacological treatment of infants. However, there is a gap in exploring implementation processes and outcomes. Future research should explore the contextual elements of the implementation by equitably examining implementation outcomes specific to the ESC model of care.
“进食、睡眠、安抚”(ESC)护理模式是一种针对被诊断为新生儿戒断综合征的婴儿的创新护理方法,可改善这一应获得公平对待人群的患者和卫生系统结局。对于将该模式可持续地应用于实践知之甚少。目的是梳理将ESC模式应用于临床实践的证据,包括实施策略、障碍和促进因素以及评估结果。
数据来源包括MEDLINE、Embase、CINAHL、PsycINFO、谷歌学术以及通过谷歌搜索确定的网站。研究选择包括自2017年该模式形成以来探索其在临床实践中的实施或评估的文章。两名评审员使用预先确定的筛选工具独立筛选每项研究。数据由两名独立评审员从纳入的文章中提取。
该综述确定了34项研究。实施ESC模式的障碍包括资源限制以及系统性压迫和偏见。促进因素包括医疗保健提供者教育和增强家长参与度。报告最多的策略类别(31.6%)包括对利益相关者进行培训和教育。在实施结果/过程的探索以及实施对公平性的影响方面存在差距。
ESC护理模式已在各种环境中成功实施,取得了积极的患者和卫生系统结局,包括缩短婴儿住院时间和减少药物治疗。然而,在探索实施过程和结果方面存在差距。未来的研究应通过公平地检查ESC护理模式特有的实施结果来探索实施的背景因素。